General self-efficacy,dental anxiety and multiple fears among 20-year-olds in Norway

This paper examines the extent to which low general self-efficacy and painful dental and medical experiences are related to dental anxiety, multiple fears and to avoidance of dental care. A total of 754 20-year-olds completed a series of questionnaires, including the General Self-efficacy Scale (GSE), Geer Fear Scale (GFS) and Dental Fear Survey (DFS). Females had lower self-efficacy, higher dental anxiety and higher scores on the GFS than males. Multivariate analyses (linear stepwise regression) indicated that painful dental experiences, a high score on the GFS and negative opinions about own dental health explained 37% of the variance in DFS scores. Self-efficacy had no predictive power for dental anxiety, and only dental anxiety had predictive power for dental avoidance behavior. Thirty-eight percent of the total variance in GFS scores was explained by the following variables: being a female, high dental anxiety (DFS), low general self-efficacy (GSE) and low educational level of the mother.     

Attitudes and uptake of a screening test: The moderating role of ambivalence

This study examined the extent to which ambivalence moderates the relationship between attitudes and screening behaviour in a clinical setting using an objective measure of behaviour. For this study 979 pregnant women eligible for prenatal Down syndrome screening completed questionnaire measures of attitudes, ambivalence and intentions towards undergoing the test. Screening behaviour, assessed by test uptake, was determined from medical records. Attitudes predicted intentions to undergo the test and screening behaviour. The correlations between attitudes and intentions and between attitudes and behaviour were greater in women with lower levels of ambivalence (r?=?0.85 and r?=?0.58, respectively) than in those with higher levels of ambivalence (r?=?0.50 and r?=?0.27, respectively). Regression analyses revealed that ambivalence moderated the relationships between attitudes and intention and between attitude and behaviour. In addition, a three-way interaction was found between ambivalence, attitudes and intention when predicting behaviour. Given that behaving consistently with attitudes is central to making an informed choice, ambivalence appears to undermine the making of such choices.     

Test anxiety and comprehension efficiency: The role of prior knowledge and working memory deficits

The hypotheses that test anxiety is associated with a deficit in prior knowledge and/or working memory capacity, that anxiety impairs comprehension efficiency, and that deficits in knowledge and capacity underlie the efficiency impairment, were tested. In Study 1, high-anxiety students were characterized by lower scores in several vocabulary measures, compared with low-anxiety students. In Study 2, high-anxiety individuals showed inferior working memory capacity to low-anxiety individuals under evaluative stress conditions, but not under non-stress conditions. In Study 3 high-anxiety subjects exhibited lower efficiency scores than low-anxiety subjects in expository texts without a summary: The former employed a greater amount of reading time than the latter to acquire an equivalent amount of information. In addition, the disadvantage in efficiency associated with anxiety was removed when differences in vocabulary knowledge were partialled out statistically. Instead, that disadvantage was only reduced, but not eliminated, when differences in transitory working memory capacity were partialled out. Therefore, the prior knowledge deficit hypothesis accounts for the impairment in reading efficiency associated with high anxiety better than the transitory working memory reduction hypothesis.     

强迫症患者抑制困难与促进效应的实验研究

强迫症的发病是抑制困难还是促进效应, 或者是两者共同起作用的缘故, 是当前强迫症研究中急需解决的问题。因此, 本研究采用国际上较为新颖的抑制与促进范式, 探讨强迫症患者的抑制困难与促进效应, 并且进一步探寻了作为焦虑障碍一种的强迫症是否与其他焦虑障碍共同存在抑制与促进效应。结果发现: (1) 强迫症患者存在抑制困难与促进效应, 但是同正常个体组相比, 促进效应较为微弱, 而抑制困难作用则更为凸显; (2) 抑制困难是强迫症患者的特有的机制, 而不是与焦虑障碍患者的“共享物”。     

焦虑障碍的认知偏向矫正元分析:效果量、影响因素及中介检验

焦虑障碍的认知偏向矫正效果及作用机制是当前一个研究热点且有争议的主题。采用元分析、元回归分析并且组合两步结构方程元分析技术,探索认知偏向矫正对焦虑障碍干预的临床和亚临床有效性,分析可能的影响因素并考察认知偏向改变在认知偏向矫正(Cognitive Bias Modification,CBM)和焦虑症状之间的中介作用。元分析共纳入46篇文献,CBM对焦虑症状干预具有虽小但显著的效果量(包含非标准化测量:g=0.29;标准化测量:g=0.26,p0.001;压力任务后焦虑症状g=0.34,p0.001),对认知偏向有中等效果量(g=0.48,p0.001);干预范式、出版特征、实验环境是焦虑症状CBM效果量的调节因素,焦虑障碍类型和实验环境对CBM认知偏向效果量有调节作用;认知偏向改变在CBM干预与焦虑障碍改变之间起显著的中介效应(z=3.13,SE=0.014,p0.001),为部分中介。将来研究可关注提升CBM症状测量或者认知偏向测量工具的信效度、发展新干预范式,尝试CBM同其他干预方式相结合,进一步探索CBM理论基础和干预机制,提升干预效果。     

Childhood trauma from a patient and a psychoanalyst perspective: linking chronic depression to relational multiple trauma

The relationship between multiple childhood trauma, as well as adversity, and chronic depression has been reported repeatedly. However, there is a lack of clinical differentiations of these findings. We complemented patient self-ratings, using the Childhood Trauma Questionnaire (CTQ), with psychoanalysts’ perspectives in order to provide finer grained clinical differentiations of the trauma behind chronic depression. These differentiations connect the trauma scales with early relational experiences. We developed a bespoke instrument derived from psychoanalytic trauma concepts. A subsample of 52 cases of chronically depressed patients alongside their 24 psychoanalysts was taken from the LAC depression study, in order to complement patient and psychoanalyst ratings. Our results confirm the connection between multiple childhood trauma and chronic depression. Besides relational trauma, the psychoanalysts’ perspective found separation trauma and transgenerational transmission of trauma to be significant. These traumatic relationships seem to precede and accompany adverse life events and/or traumatic experiences. They may even prevent adequate coping and/or processing of such experiences. Patient interview material from study intake and five-year follow-up further provides an insight into the changes the trauma narratives undergo throughout time. These changes emerged due to a joint reconstruction of the meaning of traumatic experiences throughout the course of the psychoanalytic process.     

The potential mediating role of anxiety sensitivity in the impact of mindfulness training on anxiety and depression severity and impairment: A randomized controlled trial

The benefits of mindfulness-based interventions to alleviate anxiety and depression have been supported by many studies. Given the effectiveness of mindfulness-based interventions on anxiety and depression, the underlying mechanisms need to be explored. Using a randomized waitlist-controlled design, this study investigated whether anxiety sensitivity was a potential mechanism for the impact of mindfulness training on anxiety and depression. Participants with high psychological distress were randomly assigned to an eight-week mindfulness intervention (N = 35) or a wait-list control group (N = 34). Before and after the intervention or corresponding waitlist period, participants completed measures of anxiety and depression severity and impairment and anxiety sensitivity. Separate mixed ANOVA demonstrated significant group (intervention vs. control group) × time (pre- vs. post-test) interactions for anxiety sensitivity and overall anxiety severity and impairment and marginally significant interaction for overall depression severity and impairment. Moreover, simple mediation models showed that reductions of anxiety sensitivity from pre- to post-test mediated the impact of mindfulness training on changes in anxiety and depression severity and impairment. The findings suggest that anxiety sensitivity is a potential mechanism underlying the effect of mindfulness training on anxiety and depression, which provides a new perspective for the study of processes of change of mindfulness-based interventions.     

The observer perspective: effects on social anxiety and performance

The cognitive model of social phobia by Clark and Wells (Social phobia : Diagnosis, Assessment and treatment (1995)) proposes that individuals with social phobia generate a negative impression of how they appear to others, constructed from their own thoughts, feelings and internal sensations. This impression can occur in the form of a visual image from an external, or "observer", perspective. Although social phobics use this perspective more than controls, the impact of the observer perspective has not been tested experimentally. This study investigated the effects of taking the observer perspective on thinking, anxiety, behaviour and social performance in high and low socially anxious participants. Forty-four participants (N=22 in each group) gave two speeches, one in the observer and one in the field perspective. Use of the observer perspective produced more frequent negative thoughts, more safety behaviours, and worse self-evaluation of performance in both groups. There were also clear trends demonstrating increases in anxiety and in thought belief ratings in the observer perspective compared to the field perspective. Results are consistent with the Clark and Wells model of social phobia. This study also suggests that in low socially anxious individuals, the observer perspective may contain positive information.     

The effect of pre-treatment enquiries on child dental patient's post-treatment ratings of pain and anxiety

Abstract

The aim of this study was to attempt to replicate a study in adults: to determine whether pre-treatment enquiries about anxiety and pain in children, attending the dentist, influenced their subsequent reports of pain and anxiety immediately after treatment. One hundred and ninety five children aged from seven to 16, attending four Community Dental Clinics, were allocated at random to five groups. Before treatment the first group was asked questions about their dental anxiety, expectations and memories of pain. The second group was asked about dental anxiety and expectations of pain. The third group was asked only about dental anxiety; the fourth was asked only about pain. The fifth, the control group, was asked about none of these topics. All the children were asked after treatment to rate 1) their anxiety about dentistry and 2) their experience of pain in the treatment just completed. The children experienced less pain than they had expected. There were no differences between the groups in disruptiveness or in the amount of pain experienced. However, the children who were asked about both pain and dental anxiety (groups one and two) reported significantly less dental anxiety than the control group. These results are consistent with the conclusion that pre-treatment enquiries about both anxiety and pain have no effect on disruptiveness or the experience of pain but do reduce anxiety about dentistry.     

The social phobia and social interaction anxiety scales: An exploration of the dimensions of social anxiety and sex differences in structure and relations with pathology

This study sought to provide information on the Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS) of Mattick and Clarke (1989) with respect to factor structure, relations with psychopathology, and sex differences. A sample of 200 university students completed the SPS and SIAS and various measures of anxiety symptoms and depression. The results from the factor analyses for the sample as a whole suggest the presence of three factors corresponding to scrutiny fears, social interaction anxiety, and a general level of discomfort in social interactions. The results for men replicated this structure. For women, the three-factor solution demonstrated a blurring between the types of anxiety-provoking situations, and a general discomfort in situations involving differences in social power. In general, the discomfort factor was not correlated with measures of pathology, raising the possibility that uneasiness in these situations represents a process that is not part of social anxiety. The distinction between scrutiny fears and social interaction anxiety was also supported by the pattern of partial correlations that suggests that the presence of scrutiny fears is a stronger predictor of psychopathology than is social interaction anxiety, especially for men.     

To know you is to love you: Effects of intergroup contact and knowledge on intergroup anxiety and prejudice among indigenous Chileans

Two surveys were conducted in Chile with indigenous Mapuche participants (N study 1: 573; N study 2: 198). In line with previous theorising, it was predicted that intergroup contact with the non‐indigenous majority reduces prejudice. It was expected that this effect would be because of contact leading to more knowledge about the outgroup, which would then lead to less intergroup anxiety. The two studies yielded converging support for these predictions.     

The role of the affect heuristic and cancer anxiety in responding to negative information about medical tests

Objective: Little is known about the affective implications of communicating negative information about medical tests. This research explored how affective processes – particularly the Affect Heuristic and cancer anxiety – influence the way in which people respond to such information.

Design: Participants received different types of information about PSA screening for prostate cancer and magnetic resonance imaging (MRI) scans for migraine headaches. This was a 2 (Test harm information: present vs. absent) × 2 (Test benefit information: present vs. absent) × 2 (Test recommendation: present vs. absent) between-participants design.

Outcome Measures: Perceived risk, perceived benefit and general attitudes towards PSA and MRI testing, cancer anxiety, preferences to receive the tests vs. not.

Results: As predicted by the Affect Heuristic, test harm information reduced perceived test benefits. However, information about uncertain test benefit did not increase perceived test risks. Information about the test reduced cancer anxiety, indicating defensive coping. These variables – affect, anxiety, perceived risks and benefits – all uniquely predicted test preferences.

Conclusion: Affective processes play an important role in how people respond to and interpret negative information about medical tests. Information about harms and information about the lack of benefit can both make a test seem less beneficial, and will reduce cancer anxiety as a result.     

Anxiety and performance in runners: Effects of stress and anxiety on physical performance

Abstract

The aim of this study was to investigate the effects of state and trait anxiety on physical performance under both neutral and stressful conditions. In Study I, 43 male and female track athletes answered the State-Trait Anxiety Inventory and twice underwent ergometric testing in the physiology laboratory after receiving a neutral or a stress-inducing instruction. In Study II, these 43 runners completed the state scale shortly before a test run in a practice session and once again just before the start in an official competition. Results showed a significant increase in self-reported state anxiety under the stress condition in both the laboratory and the field setting. At the same time, the mean physical performance, measured as physiological performance parameters (maximum oxygen intake, physical work capacity) or as running performance, significantly deteriorated under stress. The induced stress affected the heart rate in addition to the mere physical work load, with no sign of compensation occurring during the entire period of ergometric testing. Effects of anxiety on performance were tested by separate 2(trait) × 3(state) ANOVAs for each situation. For both laboratory situations, and for the practice situation as well, no significant relationships, neither linear nor nonlinear, were detected. In the competition situation, however, an inverted-U relationship was found in the low trait-anxious subgroup.     

The interaction effect of attentional bias and attentional control on dispositional anxiety among adolescents

Research has shown that children and adolescents with attentional control deficits tend to have high anxiety and exhibit threat‐related selective attentional bias. This study aimed to investigate how positive and negative attentional biases would interact with attentional control on dispositional anxiety. One hundred and twenty participants aged 18 years of age or younger participated in a visual dot‐probe task to measure their attentional bias and completed psychological questionnaires to measure their trait anxiety, and attentional control. Mean reaction times to the probe in milliseconds were used to measure attentional bias. Overall, our participants showed a bigger tendency towards attending to positive emotional stimuli than to negative emotional stimuli. Adolescents with high dispositional anxiety showed poorer attentional control. Regression analyses showed that attentional control interact with negative attentional bias to affect anxiety. For participants with high attentional control, higher negative attentional bias was associated with lower trait anxiety. Trait anxiety was not related to negative attentional bias for participants with low attentional control. Positive attentional bias showed no significant relationship with dispositional anxiety, either alone or in interaction with attentional control. Theoretical and clinical implications of the findings are also discussed.     

The effects of trait and state anxiety on attention to emotional images: An eye-tracking study

Attentional biases for threatening stimuli have been implicated in the development of anxiety disorders. However, little is known about the relative influences of trait and state anxiety on attentional biases. This study examined the effects of trait and state anxiety on attention to emotional images. Low, mid, and high trait anxious participants completed two trial blocks of an eye-tracking task. Participants viewed image pairs consisting of one emotional (threatening or positive) and one neutral image while their eye movements were recorded. Between trial blocks, participants underwent an anxiety induction. Primary analyses examined the effects of trait and state anxiety on the proportion of viewing time on emotional versus neutral images. State anxiety was associated with increased attention to threatening images for participants, regardless of trait anxiety. Furthermore, when in a state of anxiety, relative to a baseline condition, durations of initial gaze and average fixation were longer on threat versus neutral images. These findings were specific to the threatening images; no anxiety-related differences in attention were found with the positive images. The implications of these results for future research, models of anxiety-related information processing, and clinical interventions for anxiety are discussed.     

Negative expectations and bad relationships: Effects of negative metastereotypes on doctor–patient relationships

This research aimed to examine the effects of negative metastereotypes (i.e., patients believe that doctors have negative opinions about them) and conflict experience on doctor–patient relationships. A 2 × 2 experimental study was conducted on 84 outpatients who were randomly assigned to either a negative metastereotype activation (NMSA) condition or a nonnegative metastereotype activation (non‐NMSA) condition. Each group consisted of patients with and without conflict experience (CE). Intergroup anxiety and doctor–patient relationships were subsequently assessed. Results showed that NMSA and CE increased intergroup anxiety and undermined doctor–patient relationships. In addition, the interaction between NMSA and CE on doctor–patient relationships was significant. When negative metastereotypes were activated, patients with CE showed more unfavorable relationships with doctors as compared with those under non‐NMSA activation condition; no metastereotype effects on doctor–patient relationships were observed among patients without CE. These findings provided insights into an important predictor of doctor–patient relationships as well as its mechanism. Future studies should consider negative metastereotypes and CE to develop interventions for improving doctor–patient relationships.